This prospective study with an 18-month posttreatment follow-up evaluated the efficacy of intensive short course
chemotherapy in Greek children with pulmonary or
extrapulmonary tuberculosis. Between November, 1988, and March 1991 a 2-month regimen of
rifampin, 10 to 12 mg/kg/day,
isoniazid, 10 to 12 mg/kg/day, and
pyrazinamide, 30 to 35 mg/kg/day, followed by
rifampin and
isoniazid for the remaining 4 months, was administered orally to 36 children with
tuberculosis. Twenty-three boys and 13 girls ages 8 months to 12 years (mean, 5 1/2 years) were enrolled in the study. The diagnostic criteria for establishing
tuberculosis were
tuberculin skin test reactivity, radiographic findings compatible with
tuberculosis, epidemiological data and clinical and laboratory findings. Four children had extrapulmonary and 32 had
pulmonary tuberculosis; 9 of the latter were asymptomatic. Among the pulmonary cases there were 2 children with
pleural effusion. Clinical response to
therapy was apparent within 7 to 14 days; the
pleural effusions resolved in 2 to 6 weeks and the pulmonary infiltrates cleared in 2 to 6 months. Hilar
adenopathy regressed within 18 months or longer. No serious problems with drug tolerance or toxicity were noted during the treatment period. Temporary
hyperuricemia and transient elevation in serum
transaminases were observed in 11 patients but no
drug modification was required. There were no posttreatment relapses. These findings suggest that intensive short course
chemotherapy for the treatment of Greek children with pulmonary or
extrapulmonary tuberculosis appears to be effective, safe, of good patient compliance and comparable to the longer treatment regimens.